Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Diversion Control Plan Unchanged 517 259 0 Instruction
Notice to Treat up to 100 Patients Unchanged 500 20 0 Instruction
Notification of Intent Unchanged 1500 125 0 Instruction
Notification to Prescribe Immediately Unchanged 50 4 0 Instruction
Patient Notice Modified 1 3 0 Form and Instruction Patient Notice Patient Notice
Practitioner Reporting Form New 1350 4050 0 Form and Instruction Practitioner Reporting Form Practitioner Reporting Form
Renewal Request for a Patient Limit Increase Unchanged 1 1 0 Instruction
Request for a Temporary Patient Increase Patient Increase for an Emergency Unchanged 10 30 0 Instruction
Request for patient Limit Increase Modified 517 259 0 Form and Instruction Request for Patient Limit Increase Request for Patient Limit Increase
Total burden requested under this ICR: 4446 4751 0  
To view an IC, click on IC Title